REGISTER FOR SWIMMING! 
In
order to provide a safe and enjoyable experience for all participants, the Autism of Illinois C-U Autism Network and CUSR
(Champaign-Urbana Special Recreation) has established a drop off procedure for the swim program at CRCE. Drop off time is 6:45 pm. After entering the front doors at
CRCE, please locate the CUSR staff table to the left. If you have not filled
out an emergency sheet for your child, please do so before you sign your child in. At
that time, a CUSR staff will escort your child to the playroom behind the pool. If
your child needs to be changed into swim clothes, please inform the staff. However,
it is best if they come already dressed for swim. If your child has any specific
needs not listed please inform the staff. Please remember pick-up time is NO
later than 8:45pm.
Items
that you need to bring:
Swim
clothes and a towel
Medication
if needed
Extra
clothes if your child has an accident
Sensory
items or calming items specific to your child
*Please
make sure all items are labeled with your child’s name
Please
fill out the form below each year and the first time your child attends swimming. Thank you.
If you have any
questions, please contact the
Autism
Society of Illinois C-U Autism Network
*************************************************
CUSR EMERGENCY INFORMATION
ASI: C-U Autism Network swimming
Name:______________________________ Birthday:________________
Age:__________
Address:_____________________________ Allergies:_______________________________
___________________________________ ______________________________________
Mother/Guardian:_____________________ Special Notes:____________________________
___________________________________ ______________________________________
Home# Cell#
Father/Guardian:_____________________ Restrictions:______________________________
___________________________________ _______________________________________
Home# Cell#
Emergency Name & Phone #
Medication:______________________________
(other than Parent/Guardian)
_______________________________________
__________________________________
Preferred Hospital:_________________________
Name
Phone #
Doctor:__________________________________
__________________________________
Name Phone
#
Doctors #:________________________________
Disabilities________________________________
